Since April 2018, 271 prostate cancer patients at the Royal Liverpool and Broadgreen University Hospitals NHS Trust have been enrolled onto a new remote Prostate Specific Antigen (PSA) surveillance programme.  This remote monitoring allows surveillance tests to be undertaken on patients who have completed their treatment without the need for face to face outpatient appointments.

A dedicated administrator and senior urology nurse are working together to deliver the service which offers a more holistic approach to the long term management of patients and their life beyond cancer. This benefits both the patient and the NHS, creating capacity for additional clinical work.

The remote surveillance pathway, originally introduced in Cheshire and Merseyside in 2015, has integrated extremely well into the department and is further supported by a specialist cancer nurse and a health care assistant who care for patients newly diagnosed with prostate cancer.  Patients are then supported throughout their treatment until their care is passed to the remote surveillance team.

Mr Robin Weston, Consultant Urological Surgeon at the Trust said: “I’m delighted that the scheme has been greatly received by patients.  Our programme has significantly reduced the time spent in clinic by consultants, freeing up time for operating.  I personally, am now able to perform an additional two robotic prostatectomies on alternate weeks.

“Despite the initial difficulties associated with setting up a new pathway, our experience has been entirely positive with excellent feedback from patients who are able to contact a support worker with any queries or for reassurance.”

This online solution to information sharing and communication significantly reduces patients' travel to hospital appointments.  Surveillance consists of PSA testing (a raised PSA level can suggest a prostate problem), and results are tracked through the system.

Patients who do not wish to use the portal can continue to contact their cancer team by phone or letter.  However, staff will ensure that these patients are still registered on the portal to enable the support worker to track their appointments and test results.

Another benefit of the system is that patients are asked to complete a Health MOT at the time of the PSA blood test or may complete this at any time if they have concerns or feel their needs have changed.  This includes surveys about their overall wellbeing and allows issues such as relationships, practical and financial problems or symptoms related to their prostate treatment to be monitored.

The results of each patient's tests and health MOTs are recorded in the patient information system and after reviewing these results, the next step of follow-up is agreed.  Any ongoing concerns can be discussed over the phone and, if required, referral to other sources of suport can be made.

If a problem is identified that requires a return visit to the outpatient clinic, this is arranged without delay.  Additionally, if a patient's condition changes significantly and the pathway is no longer appropriate, the team will ensure that a package of care suiting the individual's needs is put in place and the focus is on living well after cancer.

Pic Mr Robin Weston and team.